Organization Active NPI

Begum Internal Medicine LLC

  • Legal Medicine
  • Lake City, FL
National Provider Identifier
1023453222
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME109244 Issued in FL
Legal business name
BEGUM INTERNAL MEDICINE LLC
Practice address
1283 SW State Road 47
Suite 101
Lake City, FL 32025-0489
Phone
(386) 438-5255
Fax
(386) 438-5618
NPI assigned
May 2, 2013
Last updated
Feb 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tohmina Begum, MDNPI 1366680357
Title
Owner
Phone
(203) 695-3966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X ME109244 FL Primary

Addresses

Primary practice location

1283 SW State Road 47
Suite 101
Lake City, FL 32025-0489

Mailing address

1283 SW State Road 47
Suite 101
Lake City, FL 32025-0489
Phone (386) 438-5255

Other identifiers 1

IdentifierTypeStateIssuer
107531200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130717000129 FL Part B Supplier - Clinic/Group Practice 7214177138 Receives reassigned benefits from 3 practitioners
Practice locations: Lake City, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1023453222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 SW STATE ROAD 47",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250489",
            "telephone_number": "386-438-5255",
            "fax_number": "386-438-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 SW STATE ROAD 47",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250489",
            "telephone_number": "386-438-5255",
            "fax_number": "386-438-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEGUM INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "BEGUM",
        "authorized_official_first_name": "TOHMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-695-3966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME109244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107531200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.